Individual
MRS. SHEENA ANNIECE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1585 3RD ST, FORT JOHNSON, LA 71459-5102
(337) 718-2889
Mailing address
6913 DIAMOND RIDGE DR, EL PASO, TX 79912-7697
(314) 532-6792
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1048628
TX
Other
Enumeration date
02/05/2020
Last updated
09/06/2024
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